I want to share my experience with the state run health exchange in Kentucky that is known as Kynect. Lately, it seems Kentucky has turned into the darling of the media to be used as spiteful rhetoric by those who are for the ACA (Affordable Care Act), and want to rub it in the faces of those who aren’t. While I find such things amusing at times, I am a citizen of the state of Kentucky, and I tell you right now, their exchange is very, VERY, tricky and full of loopholes. Frankly, when the auditors come around in a year, there are going to be a lot of angry residents when notices of benefit reductions and possibly fraud warning letters hit their mailboxes.

Now, to start off, I want to make it very clear that I am not against the ACA. I think the idea is a good one, though there are many tweaks and improvements that need to be made. I really wish we were converting to a single payor system, but you have to start somewhere. With that said, I was very excited to get into the insurance market places. Unlike some, I have a very real understanding of how health insurance competitiveness would actually play out. Pretty much, it will be just like the car insurance industry, and the home owner’s insurance field as well. Early prices are attractive, but there is always a bottom line none of them will go below. Ever.

My goal? Pretty reasonable. See if I could get a decent plan for what I would normally pay an employer for a decent plan. A decent plan is a $500 deductible per person, $1000 per family. $10 $20 $30 scale for RX. $25 copay for doc visits, max. Naturally there are no longer the issues of lifetime and yearly limits, so I don’t factor those in. This type of plan would normally cost me between $60 and $70 a week out of my pay check. I realize to some this might seem not the best, but this level of a plan always handled all my issues and didn’t break my bank. So the monthly premium amounted to $260 – 270 a month for me on average. This is a typical family plan in my life. I had to check out the exchanges after my employer made it clear they would not upgrade or change their policies to meet the ACA standards. Basically, they refused to remove the lifetime and yearly caps. On top of that, I was notified I would be laid off prior to the beginning of the new year, so I needed to get a plan.

Shouldn’t be so hard to find something comparable right?

Well, it all depends on how you go about filling out your application. Depends is the key word here. My family structure is a complicated one. I’m living with my ex-husband and our son. Our son has health insurance via his father’s union benefits and we have already decided I don’t need to double down on insurance for him. Additionally, most of the plans on the exchanges do not offer doubling up. On top of all this, I also have another son from a previous relationship who currently lives with his father. I pay support for that son, and when cost effective, am required to purchase health insurance for him, as does his father.

So, I need insurance for me, and insurance for my son who lives outside of my home. With this in mind, I begin my application. First thing they ask you is who is in your household. I assume they mean who do I claim on my taxes, and I just enter my own information and that of my son whom I have to buy insurance for. The next few screens are just general income information and such, then the website asks me if any of us already have insurance. Well, my boy does through his father’s work. So, I enter in all that information.

The next screen throws me into my first loop of confusion. The page I am on now is the “Absent parent” information screen, meaning my son’s father is considered absent according to the state of Kentucky because he is not listed as a member of my household. Forget the absolute marriage bias that is screaming across the screen at me when I see this, but I have to now back track and make my ex-boyfriend part of my household to avoid his getting letters from child support to pay money for a child’s healthcare policy that is living in his home! There are no options to state who has custody on any of these screens. The software just assumes that because the other parent isn’t listed in the household that he is absent. They do not take into account the mandated health insurance policies within the state’s child support framework at all. Brilliant!

So after entering in my ex-boyfriend’s information, guess what? Now his income must be counted towards mine. Even if I choose for him to not be enrolling for insurance. Is there a brick wall around here to bang my head on yet? Realizing there isn’t any logic to this madness of a website, and because unless you are all one big happy family under one roof you cannot just skate through this, I broke down and decided to call in to the customer service line. After pushing “1” for English, I am on hold for roughly six or seven minutes. Now, I am calling in mid October at this time, so the call volumes weren’t overly high yet, and I wasn’t disappointed with a long wait.

Pleasant voice greets me, I tell the representative what my issue is, and she says,”Yeah, that is a glitch we have. There isn’t a fix for it. I will just push your application on through (doesn’t explain what that entails), pick a plan and then disenroll. Then we can start you up a new application, okay?” Naturally, I agree because she knows the in and outs better than I do with this program. She has me go back online to Kynect and sign in, shows me the new application she started (the old one is still listed on the screen), and has me upload my employer information and pay stubs. She asks me if I have insurance through a job or spouse, I explain I am divorced and that my employer notified us that their policy doesn’t meet the ACA standards, and that by the beginning of the year I would be laid off. She tells me it won’t be a problem and will help me find some insurance. Then she advises that I won’t be able to get an accurate plan price for a few days while they verify the information I sent up. I don’t have a problem with that. Sounds reasonable, so I hang up.

Three days later I log back on to the Kynect website. There are two ongoing applications still, but I remember which one is the new one and open it back up. My income verification isn’t complete yet, so I still cannot get an accurate price plan. I decide to check in with the customer service department, and after another short wait, I get another pleasant greeting, I rehash the previous call’s events, and wait for her to tell me what to expect to happen next. She places me on a short hold, and when she returns to the call she sounds confused about what is going on and why I have two applications going. I explain the previous representative had said something about pushing the application on through, enrolling then disenrolling me from a plan, and that is why she was able to start a new one. The new representative falls quiet for a few seconds and asks me to hold again. I waited a good ten minutes before she got back to me on the line. “M’am, it takes up to two weeks for the income verification to be completed. I would recommend you try back then.” I didn’t like hearing this, but it is mid October and I figure another two weeks won’t matter since I couldn’t use the insurance until the first of the new year anyway, so I agree and hang up.

At this point, I want to point out I, personally, have not signed up for any insurance. Nothing. As far as I was concerned, I hadn’t even finished the application so nothing is in stone at this point. Later that day, I have some alerts in my email saying I have messages waiting for me to read at the insurance website.

You have selected the Anthem Dental Pediatric Enhanced health insurance plan on

kynect.

This is confusing, but I figure, it must be the first application finally being run through and deleted, right? This is what they told me would be done. I pay it little mind and wait the couple of weeks. I get a new email at the beginning of November:

November 01, 2013

110025908

Notice About Your Coverage

Based on the new information, coverage has not changed for these people: My name and that of my sons

(Then it gets confusing again)

*Sigh* You know, I explained that my employer’s insurance doesn’t qualify under the ACA, which means I am open to a fine, and quite frankly, I am not getting the full benefit of the ACA by having it. Thus, I needed to buy insurance, and affordably at that. So, I’m mildly frustrated. I call back to Kynect. After 55 minutes on hold, I gave up. Tried to utilize the online chat feature, but the representative on there said I had to call in so they could verify who I was. I asked her what the point of the online chat was, and she said to answer questions. Argghh. I disconnect feeling very upset and just done with it all. I’d gone without insurance for many years prior, so the heck with it right?

Well, here we are near the end of the year. A few days ago, I received a letter from Kentucky stating that my son that lives outside the home qualified for Medicaid. I also read that I had qualified too.

Honestly? I cried from relief. I cried from receiving hope. I cried from happiness. Finally, I would be healed, maybe even pain free for the first time in a good ten years. So, I started keeping an eye on the mailbox, looking for my handbook and identification cards, and when the mail arrived, I cried again.

This time out of anger. Confusion. Despair. Futility.

There was a medicaid card for my son. That was it. And rereading the original letter, something didn’t seem right. Determined to give this one more shot, I sat down immediately and brought up the Kynect website and called the customer service again. The website still showed two applications, and I waited patiently for an answer. Minutes turned into half an hour, and then forty-five minutes.

At fifty-six minutes, a woman named Shelly answered. I explained the letter I received and the medicaid card. I told her that when I had received the letter a few days earlier, I hadn’t really thought about the process of my getting it, but when I received the final paperwork and saw only my son was on it, I knew something wasn’t right. I hadn’t applied for just my son. I also let her know that I had a new job, making a good seven grand less a year. She then started asking me about my ex-husband, whom I live with, and she couldn’t decide which application to proceed with since I still had multiple ones on the website.

Eventually, she figured out the correct one, had me update my income information, update my household information, and during that process, I discovered something disturbing. My son who qualified for medicaid did so fraudulently. The Kynect representative who had E-Signed my application for me without my knowledge had marked him as deceased! She also didn’t update my son’s insurance he already had through his father! When I questioned these detail errors the representative told me to not worry about it and to hit continue.

When I had to update my income status, I had to select a reason. The representative insisted I pick “Lost my insurance due to losing my job”. I asked her why I wouldn’t just pick the “Change in household income” since I had a new job, albeit paid much less. She tells me to pick what she told me to and hit continue. At this point, I’ve had about enough. I push on through to humor her, get to the end of the application, and find I qualify for $166 in discounts each month towards my monthly premiums. My youngest still qualifies for medicaid (big wonder why), and the rates are fairly decent. Well within the $60/month range! I tell her I can handle the shopping and browsing from there, but she keeps insisting I hurry up and pick a plan! Her hurrying is frustrating and I tell her I can’t just pick a plan really quick, I need to read through the details and she can just hang up now and I will be fine. She agrees to this easily and is gone.

So I am browsing, taking in the types of options and deductibles that come with the plans. The whole process to get here still has me perturbed. All these supposed “short cuts” and “glitches” that made representatives insist I put in false information. As I flip between them, I suddenly get a screen of death from the Kynect website.

“Something has gone terribly wrong, and we will try to fix it quickly.”

Everything I had been looking at is gone! BUT, now I know how to navigate the application, and I decide to go back and “Report a change”. From there, I correct my son’s father from dead to living. I update my son’s insurance information that his father has on him. I change my reason from “Lost a job” to “Change in income”, and discover my earlier updating of my employer hadn’t saved, so I reentered that and resubmit. It is beyond me why they wouldn’t want someone to accurately report their information. My end result? I still had $166 in discounts a month, AND my son still qualified for Medicaid. To top that off? The rates were even lower.

I found a nice platinum plan for the equivalent of $30/week. I put this plan in my cart, find a coordinating dental plan to go with it for $17 a month, and go to check out. “Something has gone terribly wrong.” And when I go back to my application, all the information is gone again and I have to reenter it all over again. It does this three more times in a row, and again, I give up. Disappointed, frustrated, and just generally angry.

Kentucky’s state exchange is not smoothly sailing along like the reports say. Many folks like myself will run into issues with entering household information when we have families that do not fit the family values of a Christian ideology that this software was predicated upon. Top that off with ill trained representatives who are constantly looking for what they think are shortcuts or tricks around this biased software that will get everyone the cheapest deal possible, even if dishonestly. At the end of the day, the representatives have the authority to E-Sign on your behalf without your knowledge. You agree to let them sort out your application issue and get back to you later, and a year from now, when the state runs an audit of the Medicaid and assistance programs for insurance purchases? A lot of folks are going to lose their benefits, possibly being sent bills for Medicaid payments that should never have been made to begin with.

Use caution when allowing a representative to help you. They mean well by finding shortcuts to cheap rates, but this is federal and state money you are messing with here, and government money always demands repayment if awarded under false pretenses.